Listening to and
acting on service
user feedback
With all of us in mind

What Matters
Welcome. . .
to the first issue of What Matters for 2013 -14, which offers just a snapshot of activity
in response to service user and carer feedback.
This issue has a focus on listening to and involving service users and carers. I hope
you find it interesting and informative.
Please let us know what you think about What Matters.
Contact us at: customerservicesSWYT@nhs.net

What Matters
Customer Services
Block 10
Fieldhead
Ouchthorpe Lane
Wakefield
WF1 3SP
You can also join as a member of our Foundation Trust at:

www.southwestyorkshire.nhs.uk/membership
If you would like to share your story you can do this by visiting:

www.southwestyorkshire.nhs.uk/yourstory

Dawn Stephenson
Director of Corporate Development

1

Our Quality Account 12/13
Quality accounts are annual reports to the public from the providers of NHS healthcare.
They show what we do well, what we need to improve and the steps we are taking to
achieve improvement in quality. They reflect on the year but also look forward, explaining
what we will focus on and how we will measure how well we are doing.
People who use our services have helped us determine our quality priorities for the coming
year. We held events to gather views on priorities and what we should take into account.
Our focus remains on the following 7 priorities:
• Service users central to everything we do –
listening to and involving people who use
our services

Quality Acco

2012-2013

unt

• Access to services – to improve access,
supporting people to receive the right
care at the right time in the right place
• Care and care planning – ensuring each
person has an appropriate assessment,
care plans and treatment options
• Recording and evaluating care – ensuring
each intervention is accurately recorded
in a timely manner

With all of us

in mind

Improve and
be outstandin
g

• Working in partnership – ensuring people are supported across service boundaries
• Staff who are fit and well to care – ensuring that our staff are professionally, physically
and mentally fit to undertake their duties
• Safeguarding – improving the safety of our services for service users, carers, staff and visitors.
You can view our Quality Account at

www.southwestyorkshire.nhs.uk/quality-innovation/quality-account/

Friends and family test
The Friends and Family test is an easy to understand, comparable question which, from
April 2013, has been used in acute inpatient and accident and emergency services to
gather feedback from people who use services.
Although many of our services do not fit the target group, in order to test out what you
think about our services, we are giving people the chance to respond to this question by
including it in our surveys.
The Trust is also participating in a national pilot to test the use of the Friends and Family
test for use as a Patient Reported Experience Measure (PREM) for mental health payment
by results. The pilot will run to the end of the calendar year and twelve teams have been
identified to participate.
Payment by Results is being used by the Department of Health as a model for the
development of a mental health currency. This will provide a transparent, rules based
system to pay NHS trusts providing mental health services. This will ensure a fair and
consistent basis for funding rather than relying on historical budgets.

2

Improving Customer Service
The Trust continues to promote the importance of the best possible customer experience
through a range of initiatives, for example:
•

The Trust has introduced a training initiative ‘Right First Time, Everytime’ which has
focussed on ensuring those important first contacts with people who use, or visit, our
services are as good as they can be. The pilot courses have evaluated well and plans for
roll out to all staff are being put in place as a means of supporting a positive service user
experience and a default position of excellent customer services.

•

The Trust has just been assessed against the national Customer Services Excellence
standard. Assessment takes place across a range of criteria – customer insight, culture,
information and access, service delivery and timeliness and quality of services. Our
assessment concluded in July, with very positive initial feedback. The outcome will be
formally reported in a few weeks time. Preparation for the assessment has helped teams
to review their performance in respect of all the criteria and showcase evidence and best
practice to the external assessor.

•

The Trust is part way through a project to review the information we make available to
people who use our services. We are working closely with service users and carers to
produce a suite of information covering self-help, conditions and diagnosis, information
related to our buildings and access to them.

Where good information already exists, either locally or nationally, we are not
re-inventing the wheel, but testing this out and adapting the best to meet our needs.

We will make information available in a variety of formats to give people options on how
to access the information they need to support a good service experience.

How to contact our
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Service transformation
We are working to transform the way we deliver our services to make sure they
• meet local need
• offer best care
• enable better outcomes for our service users
• are value for money
We can only do this if we involve people who are important to us – people who use our
services, carers, staff and partner organisations.
Over the last few weeks we have held events across Barnsley, Calderdale, Kirklees and
Wakefield where we shared our vision for our services and gathered views on how best to
make progress. The events were very well attended and were rich with conversations about
how we should take services forward. We are currently collating all the feedback and will
ensure we take account of this as we form our transformation plans.
Here is just a sample of what people said:

Make sure you think
about the needs of carers.

Choice… Options….
Accessibility…

Put people in control –
for example self-referral.

Extend care plans to the
whole family.

Use technology more
effectively.

Better transport, better
parking.

Better information about
services.

Offer joint assessments so I
don’t have to tell my story
to lots of different people/
services.

Look at both my physical
and mental health needs.

Quick access – connect
services, for example
health and housing.

Develop local drop ins,
group support and buddy
systems.

Peer support – people
sharing ideas and
supporting each other.

I need services close to home
– a place to be when I’m ill
and a place when I’m better.

I need my treatment to
flow – it feels like it restarts
whenever you change.

I need you to look after
me If I’m on a waiting list.

4

At your Service
The Trust’s Customer Services Team provides
one point of contact for people who have
questions about services or who want to
share comments or make a complaint.
The Trust genuinely welcomes feedback in
all its forms to help us understand more
about what it feels like to use our services
and ways we can improve.
Each year the Trust Board receives an annual report
on Customer Services activity which collates all the
data and intelligence from feedback and reviews
learning. In the financial year 2012 /13 the following
were reported:
•

289 formal complaints, an increase on the last
two years, when 169 and 275 complaints were
recorded respectively. This increase reflects the
increased range of services now provided by
the Trust and perhaps the active promotion of
the Customer Services function to service users,
carers and staff and the wide distribution of
materials explaining how to raise an issue to
support improved service provision.

•

326 concerns raised at local level. The Customer
Services team worked with services to promote
a default position of putting things right as and
when they happen wherever possible.

•

The most common issues were care and treatment,
staff attitude, communications, waiting times for
appointments, admission, discharge and transfer
issues and service user property.

• 559 compliments were recorded. These are
acknowledged by the Chief Executive and
positive feedback is shared with teams.

5

The word cloud below shows the key words quoted in the compliments received.

supportive

genuine

help FRIENDLY empathy
caring thank you
care
fantastic
professional
individuals

helpful excellent

35 action plans covering a range of issues were implemented in the last year as a direct
consequence of service user feedback. Improvements were made across the Trustâ&#x20AC;&#x2122;s quality
priorities as follows:

Service improvements across trust quality priorities

6

At your Service
Here is a flavour of some of the improvements
we made in the year. We:
• Improved care by:
• Increasing opportunities for families to be
involved in care planning
• Improving joint working between physicians
and psychiatrists when managing complex
cases in Calderdale
• Reviewing ward round procedures in Kirklees
to ensure additional member of staff are
available to liaise with family members
• Providing more information about Infection
Prevention and Control on wards
• Providing contact details to carers to use in
the event of crisis

• Supported staff by:
• Reviews with those involved in complaints to support learning
• Training in the use of a pain management tool

• Provided better information about:
•
•
•
•
•
•
•

First appointments in our contraception and sexual health service
Therapy services in Barnsley
Bringing food into the units in our forensic services
Being a carer in Calderdale and signposting people to the support services run by the
Alzheimer’s Society
The use of beds when service users go home on leave
Ensuring staff have access to information about other local services, for example health
visiting and paediatric services
Our services to NHS Direct to help them with signposting

Reviews in a Barnsley service to prevent unnecessary delays
Checking with service users if they would find it helpful for district nurses to write
down appointment details to share with relatives and carers
Introducing a monitoring system in podiatry to ensure appropriate referrals are made
Implementing an electronic record keeping system in a district nursing team to
schedule workload and allocate care plans
An audit in a Wakefield service to ensure consistency of information recorded on
admission to the unit
An audit on patient property sheets in Kirklees to ensure that they are completed and
signed by all service users and staff on every admission
Better monitoring of answer machines for messages and regular update of
contact numbers
Improved admin to reduce waiting times in a Calderdale memory service
Advising about cancelled clinics by both letter and telephone contact in a Wakefield
community mental health team

May was admitted to an older people’s ward. She had some confusion and mobility
issues. May was assessed for the risk of falling and required a plan to help her
mobilise on the ward. The plan was not written up for four days and in that time
May suffered a fall. Her family complained to the Trust about the care and treatment
of their mother – about her deteriorating health, medication and that she fell
whilst in our care. The Trust offered an apology to May’s family, explained to their
satisfaction about the medication issues and explained what steps had been put in
place to ensure that care plans are quickly updated following each clinical input.
They remained concerned about the fall and asked the Parliamentary and Health
Service Ombudsman to review the case. The PHSO are currently in dialogue with
the Trust regarding closing this case.

Ruth needed support from the district nursing service following hip surgery. She
believed she received conflicting advice from the hospital and the district nursing
service and complained to the Trust about poor care and communication. Ruth was
unhappy that she had been advised by the hospital that she should not perform
any self-care tasks as she risked dislocation of the hip. The district nursing team
tried to encourage Ruth to self-care, for example changing her surgical stockings
and washing her legs. Following this feedback all staff now follow up on the advice
received by service users and in respect of hip surgery, do not expect the person to
bend more than 90 degrees following surgery. Nurses are also to liaise more closely
with care agencies to prevent any further misunderstandings of this nature, offering
training and support to agency staff to improve and enhance patient care.

Tom was admitted to hospital requiring care for both his mental health and a
physical illness for which he was also receiving support from local acute services.
Tom was elderly and very unwell and unfortunately died after a spell in hospital.
Tom’s family were unhappy about the perceived lack of communication and
co-ordination between the Trust and acute services and submitted a complex
complaint raising 45 issues. Meetings were held with the family to offer condolences,
to listen carefully to the issues and to agree an outcome that would help the family.
The investigation highlighted learning for services and a number of improvements
were put in place, for example increasing the involvement of families in care
planning, signposting to other services such as the Alzheimer’s Society, improving
links with acute services, sharing of diagnostic information, scan results etc, and
introducing training for staff in the use of a pain tool designed to improve pain
recognition. The family, though devastated by their loss, were grateful for the
efforts undertaken to investigate their concerns, for the close dialogue maintained
with them as the investigation progressed and for the detailed feedback offered.

8

Our commitment to carers
The Trust recognises the very difficult job thousands of carers do in supporting
family members and loved ones.
You see my wife every 6
months for half an hour – I
look after her every day
around the clock.

Earlier this month I attended
a meeting about the needs
of people who care for
someone. It was good to
meet other carers in similar
situations.

You need to consider the
needs of carers. Without us
people would need more
support from services.

We have issued a commitment to carers to set out what they can expect from us and hold us
to account if they don’t think we stay true to this.

We describe a carer as anyone who provides substantial support to a family
member or friend because they are ill, have a disability or are older.
What carers can expect from the Trust:
• Carers, many of whom are experts by experience, will be treated with respect and
listened to.
• We will enable and support your caring role by sign posting you to carers support services
that best meet your needs.
• Staff induction and training will involve carer input to enable a greater understanding of
your needs.
• You will receive jargon-free information, tailored to meet your specific needs.
• You will receive clear, up-to-date information about your relative/friend’s illness, with
service user consent.
• You will be given, with service user consent, contact numbers for the relevant people
involved in your relative/friend’s care.
• You will be involved, as much as possible, in the care and treatment of the person you are
caring for, with service user consent.
• You will be given information about any living
wills, advance decisions or statements made by
the person you care for, with their permission if
applicable.
• You will be informed about support services and
networks available to both service users and carers.
•

You will be given guidance and support when
making complaints, comments and compliments
about services and be updated on progress.
Consent is required if this involves service user
confidential information.

We will share our commitment to carers in the
coming weeks through printed products and
web based information.

9

Carer involvement in care planning
We recently conducted an audit of carer involvement in care planning, asking carers to
complete a questionnaire. Here’s some of the information people who responded to our
survey told us:
• Nearly 75% of responders had been given information about the assessed needs of the
person they cared for
• 68% knew how a care plan to support them would be agreed
• 71% felt they had been involved in understanding any risks
• 87% knew how to contact the care co-ordinator for the person they cared for
• 84% knew what signs to look for showing improvement or relapse
• 83% felt listened to by staff
• 62% had been given information on groups they might join
• 96% felt staff showed them consideration

Not enough time to get
away from my role as a
carer.

Since mum has been
receiving care and support
from the team, she has been
happier and so have I.

It’s good my husband has
a CPN.

Until recently I did feel
a little abandoned, but
more is now in place.

Talking to experts helps.

I would like to get more
involved as a carer.

Carer’s forum

A carer’s forum has been set up on a Kirklees ward to get feedback and help improve
services. The forum meets every couple of months and attracts around 30 carers. Recent
feedback has included:
• Some staff are more approachable than others. Some take the time to listen, others don’t
and carers have asked for a more consistent approach.
• How difficult a first admission is for carers and that extra time should be allowed to
acknowledge this.
• An information pack would be helpful.
• Carers have asked for extra support when people are discharged as they feel isolated and alone.
The ward is addressing the issues raised and really values the forum and the opportunity to
work in partnership with carers.

Carer support and making space
The carer support service in Barnsley offers specialist time-limited interventions and support
to carers of service users under the Care Programme Approach (CPA). The service now
meets with Making Space on a monthly basis to review potential referrals to Making Space.
Working in partnership in this way helps us to offer longer term support for carers who may
previously had been discharged from carer support services and been unable to access other
sources of support.
Carers from within secondary care mental health services can now also access Making Space
for a carer’s assessment. This is also available to carers for service users who are not under CPA.
10

You said…we listened…we did
You said

We did

In a Barnsley assertive
outreach team you told us:
• I always get the answer
machine when I call

Rearranged duties so that a member of
the team could cover reception (and the
telephone)

• Staff don’t always call you
back when you phone

Record messages in a message book and
check in team meetings that all messages
have been dealt with

• Staff are bad at time keeping –
they turn up when they want

Explained the appointment system and
encouraged people to raise this when it
was a problem

In Barnsley acute wards you:
• Requested music therapy

Introduced sessions with Q Dos dance
company

• Asked for pamper sessions

Occupational therapy and ward staff have
introduced sessions

• Asked to go rock climbing

Explained we were unable to undertake
this high risk activity but noted it might be
pursued after service users were discharged

• Said the furniture was
uncomfortable

Made scatter cushions for the seating on
Beamshaw ward

• Said it was too warm in bed

Bought new bedding to make for a more
comfortable sleeping experience

In a Barnsley CMHT you said:

11

• You wanted support in a
community setting

Reviewed day services and developed a
community based intervention team to
support people in their own homes

• Wanted a less structured
community group

Used a local community centre and developed
a peer support drop in, giving you more
control

You said

We did

In musculoskeletal services, you
said:
• You wanted a late evening
clinic to improve access

Clinics are being reorganised to accommodate
an evening clinic. The service aims to provide
a Saturday and a late night clinic before
April 2014

In contraception and sexual
health services you said:
• More confidentiality at
reception please

People providing details when they book in
now do so away from main reception

At South Dearne CMHT you
said:
• It takes too long for callers
to receive a response

We have changed our ‘front of house’
procedures and have more staff available to
meet and greet

In paediatric epilepsy you said:
• You didn’t have a care plan for
school/nursery

We explained this might be the case before
your child had a confirmed diagnosis of
epilepsy. We are aiming to have an emergency
plan for all children with epilepsy who are
nursery or school age

12

You said…we listened…we did
You said

We did

In Calderdale you told us:
• You didn’t have enough
information about medicines
and any side effects

Updated leaflets and information on the
Choice and Medication website

• It was hard to get the right
support if you had to go
to A & E

This issue is being picked up by a new
initiative to improve joint working and support
– rapid access, interface and discharge (RAID)

In Kirklees you told us:
• It was difficult to travel to
clinics if you didn’t drive

We offered options for appointments at a
number of venues

• It was difficult to get to early
appointments if your travel
permit only worked from
9.30am

Explained that appointment times can be
agreed to suit individuals

• You wanted to learn more
about psychology services

Offered a talk on psychological interventions
at a recent dialogue group

• Carers asked for training in
sharing their stories

The Equality and Inclusion service committed
to offering training later in the year and in
the meantime to share the template in use to
share stories in written form

• You wanted more involvement
in service redesign and on
estates issues

Staff updated on work at a dialogue group
meeting and explained the ways to be involved

• Shared concerns about
welfare reform

We provided information on our website to
help people understand the changes

In Wakefield you told us:
• Weekends and evenings are
vulnerable times for carers
• You asked about groups for
people with psychosis

13

Acknowledged this concern, explained when
services were routinely available and about
crisis services outside of routine care
A service manager agreed to look into this
issues raised at the recovery dialogue group
and to report back at a future meeting